MR. DONALD L JACKSON (NPI# 1073501177) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073501177 |
| Entity Type | Individual |
| Full Name | MR. DONALD L JACKSON |
| Credential | PA C |
| Practice Address |
840 S Meyers St Kettle Falls WA 99141 |
| Mailing Address |
Po Box 421 Liberty Lake WA 99019-0421 |
| Practice Telephone | 5097386607 |
| Practice Fax Number | 5097384180 |
| Mailing Telephone | 8667472455 |
| Mailing Fax Number | 5099449644 |
| Enumeration Date | 2005-10-12 |
| Last Update Date | 2014-10-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA10001811 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| L & I | 127584 | 01 | |
| WA | 8118986 | 05 | |
| L & I CRIME VICTIMS | 8935341 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700200086 | Donald Jackson Jr. | Preventive Medicine | 2500 E Grand Blvd, Medical Dept, Detroit, MI 48211-2006 | 2014-02-07 |
| 1942577200 | Donald Jefferson Jackson | Social Worker | 434 Atkinson St, Laurinburg, NC 28352-3714 | 2011-11-30 |
| 1366684839 | Donald Wayne Jackson | Case Manager/Care Coordinator | 3434 Mount Burnside Way, Woodbridge, VA 22192-1013 | 2009-03-30 |
| 1760500649 | Donald William Jackson | Dentist | 1909 A Mission 66, Vicksburg, MS 39180-3711 | 2007-03-27 |
| 1588722466 | Donald A Jackson | Psychologist | Nced Ms 285, University of Nevada, Reno, Reno, NV 89557-1285 | 2006-12-05 |
| 1215310115 | Donald Lee Jackson Jr. | Counselor | 1030 Village Dr Ste B, Watkinsville, GA 30677-6004 | 2015-07-09 |
| 1811185721 | Donald John Jackson | Social Worker | 63 Harmony Hill Rd, Chepachet, RI 02814-1429 | 2007-10-05 |
| 1588876965 | Donald Murphy Jackson | Dentist | 712 S Main St, North East, MD 21901-4126 | 2007-05-05 |
| 1609997584 | Donald L Jackson | Counselor | 1012 14th St Nw, Suite 1000, Washington, DC 20005-3403 | 2007-04-02 |
| 1407947039 | Donald J. Jackson | Physician Assistant | 185 Grafton Rd., Townshend, VT 05353 | 2006-09-27 |
| Street Address |
840 S MEYERS ST |
| City | KETTLE FALLS |
| State | WA |
| Zip Code | 99141 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043208135 | Samuel A Artzis | Family Medicine | 840 S Meyers St, Kettle Falls, WA 99141 | 2005-10-12 |
| 1558748285 | Steven Tingey | Physician Assistant | 840 S Meyers St, Kettle Falls, WA 99141-7005 | 2015-05-01 |
| 1538413109 | Providence Health & Services Washington | Clinic/Center | 840 S Meyers St, Kettle Falls, WA 99141-7005 | 2012-11-05 |
| 1932285715 | Kerry A Michaelis | Physician Assistant | 840 S Meyers St, Kettle Falls, WA 99141-7005 | 2006-10-27 |
| 1326055831 | April S. Hume | Family Medicine | 840 S Meyers St, Kettle Falls, WA 99141-7005 | 2006-08-01 |
| 1780672725 | Edward D Johnson | Family Medicine | 840 S Meyers St, Kettle Falls, WA 99141 | 2005-10-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568739704 | Marnie Michelle Sly | Pharmacist | 1250 North Highway 395, Colville, WA 99141 | 2011-11-16 |
| 1902026248 | Fredrickson Chiropractic Clinic Ps | Chiropractor | 355 W 3rd St, Kettle Falls, WA 99141 | 2007-04-27 |
| 1336278233 | Shelley Sue Ericksen | Massage Therapist | 325b Third Ave, Kettle Falls, WA 99141 | 2007-03-05 |
| 1497807499 | Carrie Corbin | Specialist | 325 E 3 Rd Ave, Suite B, Kettle Falls, WA 99141 | 2007-01-18 |
| 1871668251 | Donna Bedgood Rosen | Counselor | 475 Meyer St, Kettle Falls, WA 99141 | 2006-11-21 |
| 1760552939 | Susan Lee Ridlington | Physical Therapist | 355 W 3rd, Kettle Falls, WA 99141 | 2006-11-08 |
| 1750460218 | Ron J Fredrickson | Chiropractor | 355 W. Third Avenue, Kettle Falls, WA 99141 | 2006-11-03 |
| 1962505099 | Kettle Falls School District | Local Education Agency (LEA) | East 225 8th Street, Kettle Falls, WA 99141 | 2006-09-06 |
| 1821128539 | Valley Drug Co | Pharmacy | 280 W 3rd Ave, Kettle Falls, WA 99141-0435 | 2007-03-06 |
| 1104451020 | Caitlyn Marie Aubertin | Massage Therapist | 25193 Highway 395 N, Kettle Falls, WA 99141-5006 | 2020-03-11 |
| Find all providers in zip 99141 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558748285 | Steven Tingey | Physician Assistant | 840 S Meyers St, Kettle Falls, WA 99141-7005 | 2015-05-01 |
| 1932285715 | Kerry A Michaelis | Physician Assistant | 840 S Meyers St, Kettle Falls, WA 99141-7005 | 2006-10-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831790591 | Bailey Mantha-nagrant | Physician Assistant | 7912 170th Ave Ne Unit 301, Redmond, WA 98052-0907 | 2020-11-07 |
| 1518567791 | Addison Christine Richert | Physician Assistant | 121 Kingfisher Pl, Port Hadlock, WA 98339-8733 | 2020-10-28 |
| 1992312177 | Robert Monsees | Physician Assistant | 490 Packwood Ln, Ellensburg, WA 98926-8027 | 2020-09-30 |
| 1649887548 | Jesse E Davis | Physician Assistant | 3512 Serene Way, Lynnwood, WA 98087-5202 | 2020-09-25 |
| 1558977066 | Kimberly Ho | Physician Assistant | 23004 88th Ave W, Edmonds, WA 98026-8616 | 2020-09-20 |
| 1770198954 | Ashish Chaudhary | Physician Assistant | 1215 Dexter Ave N Apt 704, Seattle, WA 98109-3567 | 2020-09-14 |
| 1144835422 | Juleeann Stocking | Physician Assistant | 1517 17th Ave S, Seattle, WA 98144-3522 | 2020-09-13 |
| 1891309555 | Andrew Allyn Bloom | Physician Assistant | 5889 Bow St, Bow, WA 98232-8620 | 2020-09-01 |
| 1558973909 | Margaret Webster | Physician Assistant | 6501 36th Ave Nw, Seattle, WA 98117-6010 | 2020-08-18 |
| 1033720495 | Riley Richardson | Physician Assistant | 1008 E Windemere Ct, Spokane, WA 99223-6228 | 2020-08-11 |
| Find all providers with the same taxonomy | ||||
| City | KETTLE FALLS |
| Zip Code | 99141 |
Please comment or provide details below to improve the information on MR. DONALD L JACKSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.